The present invention relates to orthopedic treatment and, in particular, the present invention relates to systems for orthopedic treatment in which patient treatment protocols are reduced to digitalized representations for use in conjunction with portable computerized or digitalized orthopedic treatment devices. The present invention also relates to selection or creation of an appropriate patient treatment protocol, as well as intervention and control to modify the patient treatment protocol. In particular, this aspect of the present invention also relates to modification of a patient treatment protocol when the modification is contingent upon certain events related to feed-back data recorded by a computerized orthopedic treatment device.
Orthopedic treatment historically involved a treatment professional, normally a physician, examining and diagnosing an orthopedic injury in a patient, prescribing a treatment protocol of activities or exercises for the patient to follow in order to facilitate healing, and subsequent re-examination to assess patient progress. Additionally, the patient was traditionally guided and assisted in following the prescribed treatment protocol by other treatment professionals, such as physical therapists, who could inform and advise the attending physician concerning patient compliance with the protocol and communicate and assist with the patient to provide desired activity details and elicit patient response. The traditional treatment path often included either hospitalization or patient visits at a physical therapy facility.
In modern times, financial pressure upon the medical arts and the surrounding medical industry has increased the number of patients each physician must treat and reduced the rate of hospitalization. There is a tendency to employ physical therapy facilities, as well as reduce the direct supervision of the patient activities by the physical therapist. Computerized devices have been developed that at least augment the physical therapist contact, and monitor patient activities under a treatment protocol. One particularly innovative device system, the IZEX sensor-instrumented orthosis and associated hand-held Smart IDEA(trademark) computer/communicator, not only replaces some of the physical therapist""s function of (1) advising and instructing the patient and (2) advising the attending physician of patient outcome and compliance, but also allow an improved (quantitative) measuring and monitoring of patient rehabilitation activities and exercise parameters, such as effort exerted in rehabilitation exercises or stress applied to the orthopedic injury. This improved monitoring enables exploitation of a long observed and literature-documented phenomenon of improved recovery in response to appropriately applied exercises to orthopedic injuries. The topic of accelerated and improved recovery through the use of controlled bio-feedback based rehabilitation has been reviewed extensively by one of the present inventors in patents U.S. Pat. No. 5,052,375; U.S. Pat. No. 5,368,546; U.S. Pat. No. 5,484,389; U.S. Pat. No. 5,823,975; and U.S. Pat. No. 5,929,782 and the entire disclosures of these patents are incorporated herein by reference.
In spite of advances such as the IZEX SmartIDEA(trademark), the ultimate goal of efficiently achieving an optimal yet accelerated recovery outcome has remained elusive. This is, at least in part, because the utilization of the IZEX(trademark) orthosis brace system and SmartIDEA(trademark) computer/communicator previously have continued to rely upon a treatment professional performing an examination, generating a diagnosis and subsequently providing a treatment protocol for the injured patient. The SmartIDEA(trademark) hand-held computer was then programmed based upon the protocol. The treatment professional may not readily know nor have available information concerning the optimal treatment protocol for an accurately diagnosed injury. It would be a significant advance in orthopedic treatment if a physician or other treatment professional could be rapidly advised concerning optimal treatment information based upon up-to-date experiential outcomes of similar treated injuries. It would also be a significant advance if the physician or treatment professional could leverage their own expertise and their colleagues""most recent knowledge to appropriately modify and adapt previously successful protocols for a new patient. It would also be a significant advance if the protocol could be installed in a handheld computer (monitoring device/ computer/ communicator) device with ease and efficiency. Additionally, it would be a significant advance to allow appropriate progress-based and time-based modification of the patient""s protocol. Modification may be best thought of as intervention. Intervention, most particularly real-time modification, into rehabilitation exercise protocols by a patient or in response to a patient request or by a treatment professional or by an automated computer algorithm, where such modification is limited by reasonable constraints, would also offer further progress toward the goal of efficiently achieving an optimal, yet accelerated, orthopedic recovery outcome. A system which provides real-time intervention can also allow delayed intervention. Intervention can be initiated by the patient, by the treatment professional, or by the automated computer system. The following system provides such advances to the orthopedic arts.